Prospective investigation of Oswestry Disability Index and short form 36 subscale scores related to sagittal and coronal parameters in patients with degenerative lumbar scoliosis

Stiffness-related disability following long segmental posterior instrumentation and fusion: is it influenced by postoperative spinopelvic alignment?

PURPOSE

The aims of this study were to investigate the correlations between Chinese version of Lumbar Stiffness Disability Index (C-LSDI) and other clinical outcomes, and to identify the factors independently affecting stiffness-related disability after long-segment fusion in patients with degenerative lumbar scoliosis (DLS).

METHODS

We performed a retrospective study of 118 consecutive surgically treated DLS cases at a single institute. Pre- and post-operative radiological parameters and postoperative health related quality of life (HRQOL) were examined to determine their correlation coefficients with postoperative C-LSDI. Patients were divided into two groups by the medium number of postoperative C-LSDI: low-stiffness group (C-LSDI < 48 points) and high-stiffness group (C-LSDI ≥ 48 points). Subsequently, differences between the two groups were assessed, and the presumed factors affecting C-LSDI evaluation were further analyzed.

RESULTS

Coronal parameters and global sagittal parameters showed significant correlations with postoperative C-LSDI. The correlation coefficients between C-LSDI and Oswestry Disability Index (ODI), Japanese Orthopedic Association-29 (JOA-29), the Scoliosis Research Society-22 questionnaire (SRS-22) Function, and the Short Form-36 Health Survey (SF-36) Physical Component Scores were over 0.5. In multiple linear regression, postoperative sagittal vertical axis (β = 0.084, p = 0.025), fusion levels (β = 2.13, p = 0.012), and body mass index (β = 0.867, p = 0.022) were independent related factors for C-LSDI.

CONCLUSION

This study showed that all HRQOLs demonstrated the varying degree of correlations with C-LSDI, of which the ODI, JOA-29, SRS-22 Function, and SF-36 PCS were most relevant, with moderate strength of associations.Moreover, longer fusion levels, higher BMI, and greater postoperative SVA independently affect C-LSDI after long segmental posterior instrumentation and fusion for DLS.

Determination of predictors associated with pain in non‑surgically treated adults with idiopathic scoliosis

BACKGROUND

It is recognized that pain related to adult individuals with idiopathic scoliosis (IS) substantially impacts individuals' daily activities and quality of life. The objective of this study was to identify the possible predictors of pain intensity in non‑surgically treated adults with IS.

METHODS

This cross-sectional study included 58 adults individuals with Lenke type 1 IS. Participants' sociodemographic characteristics were recorded, and pain severity, curvature severity, trunk rotation angle, disability, spinal mobility, cosmetic deformity perception, and quality of life were assessed. Regression analyses with various models were performed to determine the predictors of pain severity and the best model was selected based on performance criteria.

RESULTS

Strong associations were found between pain severity with curvature severity, spinal mobility, trunk rotation angle, perception of cosmetic deformity, disability, and quality of life (p < 0.05). It was observed that Lasso regression was the best model based on the performance criteria considered. According to this model, the primary predictors of pain intensity in adult IS were determined as curvature severity, spinal mobility, trunk rotation angle, cosmetic deformity perception, back-related disability and quality of life, in order of importance.

CONCLUSION

In accordance with the findings of this study, which examined for the first time the determinants of pain intensity in adult individuals with Lenke type 1 IS, we suggest that mentioned possible factors affecting and determining pain should be taken into consideration when establishing evaluation and treatment programs.

Relationship between paravertebral muscle function, pelvic incidence, and health-related quality of life in patients with degenerative spinal deformity

BACKGROUND

Patients with degenerative spinal deformity often experience symptoms that seriously affect their quality of life, such as low back pain and dysfunction. This study aimed to investigate the relationship between paravertebral muscle function and pelvic incidence (PI) and their effect on health-related quality of life (HRQL) in patients with degenerative spinal deformity.

METHODS

A total of 112 patients with degenerative spinal deformity in Southwest Hospital (Chongqing, China) were enrolled. They were divided into groups according to PI angle: high (PI > 60°, n = 37), normal (PI 50°-60°, n = 31), and low (PI < 50°, n = 44). Paravertebral muscle strength and endurance were assessed using the prone external fixation test frame. The sagittal vertical axis (SVA) was measured on X-rays of the spine in an anterolateral position, and all subjects were assessed with the Oswestry Disability Index (ODI), Roland-Morris questionnaire (RMQ), and 36-Item Short Form Health Survey (SF-36). Pearson or Spearman coefficients were used to assess the relationship of paravertebral muscle function with SVA, PI, and health-related quality of life.

RESULTS

Maximal voluntary exercise (MVE) in the high-PI group was significantly lower than the MVE of both the normal- and low-PI groups (p < 0.05). There was no significant difference in MVE between the normal- and low-PI groups (p > 0.05). There was no significant difference in endurance time, SVA, ODI, RMQ, and SF-36 among the three groups. Paravertebral muscle MVE was negatively correlated with PI, SVA, ODI, and RMQ (r = - 0.193, - 0.210, - 0.283, - 0.277, p < 0.05). Endurance time of paravertebral muscle was also negatively correlated with SVA, ODI, and RMQ (r =  - 0.200, - 0.420, - 0.348, p < 0.05) and positively correlated with SF-36 (r = 0.245, p < 0.05). In addition, paravertebral muscle MVE was positively correlated with the physical functioning score of the SF-36 (r = 0.251, p < 0.05), and the endurance time of paravertebral muscle was positively correlated with the physical functioning, physical role, bodily pain, and social function scores of the SF-36 (r = 0.342, 0.230, 0.209, 0.256, p < 0.05).

CONCLUSIONS

High PI may serve as a risk factor for decreased paraspinal muscle strength in patients with degenerative spinal deformities. Early and targeted exercises focusing on paraspinal muscle strength and endurance could potentially be of positive significance in slowing down the progression of sagittal imbalance, alleviating functional disorders, and increasing health-related quality of life in patients with degenerative spinal deformity.

The Difference in Paraspinal Muscle Parameters and the Correlation with Health-Related Quality of Life among Healthy Individuals, Patients with Degenerative Lumbar Scoliosis and Lumbar Spinal Stenosis

(1) Background: Paraspinal muscle degeneration affects the quality of life in patients with degenerative lumbar scoliosis (DLS) and lumbar spinal stenosis (LSS). We aimed to describe the characteristics and differences in the paraspinal muscle parameters between patients with DLS and LSS and investigate their correlation with health-related quality of life (HRQOL). (2) Methods: There were forty-four participants in each group, namely the DLS, LSS, and healthy groups, who were matched at a ratio of 1:1 according to age, sex, and BMI. Differences in paraspinal muscle parameters among the three groups were compared using analysis of variance or the Mann-Whitney U test, and paraspinal muscle degeneration and HRQOL were analyzed using Spearman's correlation analysis. (3) Results: In the upper lumbar, the psoas (PS), quadratus lumborum (QL), and multifidus (MF) cross-sectional area (CSA) in the DLS group were smaller than those in the other groups. In the lower lumbar region, the CSA of the PS, QL, erector spinae (ES), and gross CSA (GCSA) of the MF in the DLS group were not significantly different from those in the LSS group. These values were lower than those observed in the healthy group. The lean muscle fat index (LMFI) of the MF and ES groups was higher than those of the other groups. Regarding HRQOL, we found that PS and MF CSA were strongly associated with HRQOL in healthy individuals; however, only MF was associated with HRQOL in the LSS group. (4): Conclusion: PS in the upper lumbar region and MF degeneration were more severe in patients with DLS than in those with LSS. ES degeneration was similar between the LSS and DLS groups. MF muscle atrophy in patients with LSS and asymmetric changes in the MF in DLS are associated with quality of life.

Association of Various Spinopelvic Parameters and the Quality of Life in Those With Degenerative Lumbar Scoliosis in the Indian Population

Purpose The current study aimed to find any association between various spinopelvic parameters and the quality of life in patients with degenerative lumbar scoliosis (DLS) measured as per the Oswestry disability index (ODI) and visual analog scale (VAS) in the Indian population. Methods We included 20 DLS patients of more than 40 years with a Cobb angle of more than 10° and without any trauma, tumour, infection, or congenital scoliosis presented in our tertiary care centre in the study. The VAS and ODI were calculated for each patient. Radiological parameters were recorded for every patient, including sagittal balance, coronal balance, Cobb angle, pelvic incidence, pelvic tilt, and lumbar lordotic angle. We evaluated the results and sought any association between clinical and radiological variables for DLS. Results Patients with positive sagittal balance had significantly higher disability than those with neutral sagittal balance (p-value 0.007). Furthermore, patients with coronal imbalance had more severe pain (p-value 0.013) and disability (p-value 0.038) than those with neutral coronal balance. We also found that the ODI and VAS were not associated with any other spinopelvic parameters. Conclusion From the present study, we can conclude that in the Indian population, both positive sagittal and coronal imbalances are associated with poor functional status in patients with DLS. Therefore, while planning surgical correction for these patients, both coronal and sagittal balance are important and need to be considered.